The story said that a study showed the new treatment improved strength and decreased pain from tennis elbow — but it never said by how much or how this improvement was measured. We also never learn about important limitations in the study design that should have been mentioned. A link to the study abstract provided in the story wasn’t sufficient to address our concerns on these points.
As this story points out, tennis elbow isn’t confined to the country club set and can do a lot more than throw off your serve. It can also directly threaten the livelihood of painters and other manual laborers whose movements are restricted by debilitating pain. Since there is no single treatment that is broadly effective for this condition, the identification of new therapeutic approaches, such as the FlexBar discussed in this story, is an important research priority.
The story states that the FlexBar costs between $16 and $33. It could have compared this cost with that of some other treatment options, which can be quite expensive.
The story makes no attempt to quantify the benefits associated with the FlexBar, and we don’t think linking to the study abstract is sufficient to satisfy this criterion (especially when the full text of the published study is also available online). The average reader can’t be expected to interpret differences on a “visual analog pain scale” or “DASH questionnaire” without some explanation of what these measures mean.
The FlexBar is probably safer than some other commonly used treatments for elbow pain such as steroid injections. However, the story doesn’t really address safety, except to say that traditional hand weights can sometimes make tennis elbow pain worse (and by implication, that the FlexBar won’t). While this isn’t a major concern of ours, we think it’s probably premature, based on a single 21-person study, to suggest that the FlexBar is safer than other noninvasive approaches to treating tennis elbow.
The story cites a study which documented improved strength and less pain among patients who used the FlexBar device. Although it links to an abstract of the study presented at a conference, the story made no attempt to evaluate the quality of this research or address its limitations. On the positive side, the study was a randomized, controlled comparison of adding the FlexBar to a traditional physical therapy program for tennis elbow — a relatively strong design. But the study’s very small sample size (21 patients) and short duration (7 weeks) are important limitations that should have been mentioned. Tennis elbow frequently relapses, so it is unclear if the short term relief reported here will translate into a longer-term benefit for patients.
The story did not overstate the consequences of tennis elbow, which can cause debilitating pain that interferes with work and activities.
The story notes the involvement of the FlexBar manufacturer in the study that is referenced. It also quotes an independent physical therapist who suggests there are other ways to achieve the effect attributed to the FlexBar.
The story mentions other treatment approaches to tennis elbow, including ultrasound, strengthening and stretching exercises, cross-friction massage, heat and ice.
It is clear from the story that the FlexBar is commercially available.
The story earns credit for noting that there are other ways to achieve the effects attributed to the FlexBar (as an expert source points out, “There’s a variety of methods you can use to achieve the strengthening technique.”). However, the story didn’t satisfactorily address what is new and potentially important about this treatment–which is that it allows patients to do isolated eccentric exercises for tennis elbow at home. The only way patients could do this previously was in the clinic using an expensive machine. An at-home treatment would make this kind of therapy much more affordable and easier to access, which might also make it more effective.
Nonetheless, we’ll give the brief blog post the benefit of the doubt since it ended with the note: “The FlexBar is easy to use and you can do it at home.”
This story wasn’t based on a news release.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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